Saturday 16 December 2017

My mother died from breast cancer – should I now be tested to find out if I carry the gene?

I'm wondering if I should be tested for the breast cancer gene. My mother died of cancer a few years ago and her original diagnosis was breast cancer. Since then, I've witnessed so many members of my broader family being diagnosed with various cancers. Everywhere I turn, members of my family seem to be coming down with it. I've started to become obsessed with what I eat and the chemicals in my food.

It doesn't help, I guess, that I'm watching these reports on TV of people having preventative double mastectomies because they discovered they had the gene. I'm a single woman in my mid-thirties, just recently out of a relationship. I'm hoping I will meet someone to start a family in the next couple of years because I really do want to have children.

It was after seeing an interview with Michelle Heaton that I heard her say she never thought of having the test done until after her child was born. Then when she tested positive, she thought it was a no-brainer to have her breasts removed so at least she was increasing her chances of having a long life with her child. I keep thinking I should get the test done even though I'm not even sure what the test is.

Then again, if the test turns out positive as in Heaton's case, does that mean I should consider a double mastectomy? What would any man think if I told him I had my breasts removed as a precaution? Then if I'm at risk of breast cancer, am I at risk of ovarian cancer too and if I was being really cautious should I also have my ovaries removed?

My sisters laugh at me. They call me a hypochondriac and tell me just to relax and let things happen as they are meant to be. I think it's easier for them because both of them have children and great husbands.

The thing is I've never been able to take life as it comes. Who doesn't want to feel in control of their lives?

Gosh, I can see where your sisters are coming from. You are a bit of a worrier. When any of us look for the prevalence of cancer in our families, most of us are going to come up with the same sort of statistics you have. I understand your worry though, and I do think you're right thinking that cancer is everywhere. No doubt early diagnosis of certain cancers is key.

However, there is also plenty of evidence to show that stress does little in the battle against cancer.

There are arguments for taking the test for the breast cancer gene but there are questions you need to ask yourself first.

The breast cancer genes BRCA1 and BRCA2 account for about 3-5pc of breast and ovarian cancers, as far as we know. You can inherit the gene but not necessarily develop cancer. Women who develop a pathogenic mutation of the gene have a 60-85pc lifetime risk of developing breast cancer and a lifetime risk of ovarian cancer of between 15pc and 40pc.

It should be borne in mind that this is still a lifetime risk and, as you point out, the chances of any of us developing cancer in our lifetimes is frankly pretty high. So why bother with the test? Well, given what we know about the ability to tackle cancer early or prevent it, it may be a way of avoiding the disease altogether.

Accessing the test isn't that straightforward, though. My understanding is that those performing the test will want to test the person with cancer first to see if they are carrying the gene, then they will test you to see if you have inherited the gene. Before such tests, you will be asked about your family history of cancer.

Having a parent with cancer is not a definite indicator that you should be tested. If your mother was young when she was initially diagnosed, they may be more anxious to have you tested.

The next stage is what you do with this information. A negative result meaning you don't have the gene doesn't mean that you won't go on to develop cancer anyway.

If you were to receive a positive diagnosis, what then? Leave the future male partner out of it; the first person who is going to have to come to terms with her body is you. Would you consider reconstructive surgery? What would that involve and what is the cost? If you did go down this route, would you then relax and not obsess about it again?

Trying to control your life is not the healthiest way to live. How much of your life is passing you by while you are worrying about having a gene that may mutate or not, and that may one day cause cancer? Instead of fretting, you need to take time out, go to yoga, consider meditation.

Your mother's death was clearly upsetting and that may still play on your mind a lot. Talk to people about it but do see if there are ways of letting go of all the upsetting thoughts that are troubling you. We don't know what's ahead for any of us, so try and enjoy the healthy life you have now.

Orla Barry presents 'The Green Room' on Newstalk 106-108FM on Mondays from 10pm-12am.

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